I’ve met a man and want to start a family – but I’m scared of penetration

I’m 26, in love with an amazing guy, and very excited about the thought of having a child. My problem is with sex, specifically penetration. I’ve had two attempts at penetrative sex in the past but it felt so uncomfortable it left me for years thinking I had vaginismus. Since then I’ve mostly avoided penetration. However, I’ve realised recently (after being intimate with my boyfriend) that the problem is not physical but psychological. In the past, I was shamed for wanting tampons by my mum, so I didn’t attempt to use one until I was older. I want to move past this problem, but I don’t know where to start and I am so scared.

Everything you are dealing with is treatable, so be hopeful! Your first task – and it is an extremely important one – is to find a physician with whom you feel safe enough to allow a physical exam. This is because it is possible there may be a physical issue that needs to be treated and resolved.

If physiological factors are ruled out, you can start working on your fear of penetration. If your fear of penetration is so great that you could not allow a doctor to examine you, you must seek some psychological help. Depending on the cause, a qualified psychologist could provide anxiety-reducing treatment, hypnosis, or treatment for trauma or phobic reactions. In addition, a sex therapist could be invaluable. Don’t wait to seek treatment.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

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